Some you win

Six emergency calls; all requiring an ambulance.

Part of my job involves chore-like activities, such as running down to the comms people to get the radio repaired. Doing something like this is fraught with risk – it can take hours to change a fuse down there. I hate hanging around doing nothing, as do many of my colleagues when they are subjected to the same miserable fate.

I found my radio dead this morning. It was lighting up but no sound was going to or coming from it; my radio was in VF. I let control know and they instructed me to get the car battery checked out. Now, I’m no mechanic but if the thing is lighting up I’m guessing there isn’t a power deficit but I wasted an hour on the escapade anyway then took the car, myself and my dumb-struck RT buddy down to the radio hospital where they would tinker and meddle and offer some kind of lame explanation before replacing the whole lot out of spite.

It took almost three hours to escape the clutches of the radio men. I had read, and got bored of, a book and a couple of magazines by the time they released me from the hell I was in. There were at least four other LAS vehicles and crews down there – all with minor problems that required hours of mucking around for reasons none of us understood. Maybe we pay these guys by the hour.

Eventually I started my shift with lunch time nipping at my heels and my first call was for a 31 year-old who had been cycling along the road when he came to blows with a lorry. He lost. After the incident he jumped into a taxi and delivered himself to a police station, complaining of abdominal pains and requesting that they call an ambulance – half an hour after the RTC.

Is it me or could this guy have delivered himself straight to hospital just as easily? Could he possibly have waited at the scene of the incident for police and ambulance rescue? It just goes to prove that you don’t have to be drunk to be stupid.

I checked him out and the ambulance took him away.

A 52 year-old female who had fainted a couple of times was already being attended to by the ambulance crew and I was not required so I got myself out of sight and completed the paperwork, which amounted to me writing ‘not required’.

Once again the walk-in centre called on us to get them out of trouble. An 83 year-old man had presented himself for a routine appointment but passed out during his chat with the doctor. He man regained consciousness and she took his blood pressure; it was very low. She called an ambulance. Fair enough, he certainly needed to go to hospital.

When I arrived nobody knew what I was there for, so that caused a delay. Eventually, they sent me upstairs and the doctor greeted me at the door of her surgery. The man was inside. He was sitting slumped in a chair – unconscious. His wife was with him and she looked confused. I was confused too – why wasn’t he lying down?

I dragged the chair and the man over to the examination couch and hauled him onto the bed. I know I could have dragged him to the floor but I thought it would be easier to transfer him from couch-height when the crew arrived. I asked the doctor to elevate his feet whilst I opened his airway and continued to try for a response. After a few seconds he opened his eyes and acknowledged me. Within a few minutes he was ‘back in the room’. He looked ill and had a medical history to accompany his current problem, so he was definitely going to hospital.

His BP improved somewhat but it still wasn’t great and when the crew arrived to take him away a fluid supplement was being considered. I still don't know why the doctor did nothing about her chair-bound unconscious patient.

I wandered into the West End (the weather is improving) for a cruise around when I received a call for a 27 year-old, suspended. I looked again at the age and considered the odds. This was probably not as given but I heard Control giving details of the job to a motorcycle paramedic and the word suspended was used again, so it was probably for real. I stepped up a gear to get there as fast as I could; if this was genuine the patient had minutes to survive (it wasn’t made clear if CPR was being carried out).

I found myself behind an ambulance that was on the way to the same job and armed police guided us into the area. I wondered if this was a shooting because there were armed cops everywhere. Later I realised they had nothing to do with it; the origin of the call was behind an embassy building. A few of the police officers were soon roped in to help us though.

I went into the house and there were already a number of people dealing – two ambulance crews and one MC paramedic. CPR was underway on a young woman lying on the floor and I offered my help. Most of the people on scene were paramedics, so every skill role was filled, except the drugs. I got my drugs pack out and selected what might be needed for the patient just as a shock was called and delivered. This single shock changed the young woman’s fate – it brought her back. She began gasping and convulsing. Her airway was a mess and the paramedic attempting to intubate her before the shock had found it impossible to get a clear view. It was moot now – she could be supported with an airway and a bag and mask.

I suggested we load and go because there was nothing else we could do at this stage; she needed to be sorted out in hospital. I brought the trolley bed in with the help of an armed-to-the-teeth police officer and we lifted her onto it and wheeled her out to the ambulance. Absolutely no more time was wasted and I travelled with the convoy to the nearest resus room, where she continued to struggle for survival.

The woman had just collapsed and gone into cardiac arrest without an obvious cause. I suggested checking her BM but it was normal, then I saw her convulse and posture on the resus bed and it reminded me again of the little boy we had saved a few months ago and the woman I had been told would probably not survive after her sub-arachnoid. I think this woman was suffering a brain bleed. I also think she will survive and that made me feel good about the team effort. I know I played a small part in this one but it’s still nice to witness a recovery.

After that job I got a little time to rest, replenish kit (not that I used much) and clean myself up a bit – can’t have the general public thinking we are an untidy lot. I went back out on ‘patrol’ and got sent to a female who was vomiting in a car in a McDonald’s car park. Nothing unusual in that surely, I thought.

When I arrived, she was sitting at the wheel looking very off-colour and sweaty. She had vomited on the ground and had driven into this establishment to use the toilet (she had diarrhoea) – we call this combination of bad fortune D&V (never the other way round). It is written this way to make things easier on paper and also because diarrhoea is one of those words that most people simply can’t spell!

It all sounded like a touch of food poisoning and her presence in the McD. car park was not helping publicise their products, so an ambulance took her away to the nearest hospital. There was an old man with her and he couldn't drive so he was left with the car (for security) – he kept wandering up to me while I completed my paperwork and chatting about stuff – mainly the weather. I nodded where appropriate and smiled where necessary but I really had to get on with it and small-talk isn’t my thing – it really isn’t.

My shift was about to end and I had a mere thirty minutes to go when Control sent me a 19 year-old female (not literally) with DIB and chest pain. Once again, given the age of the patient I was a little sceptical.

I arrived at a house inhabited by a large family. The kids were outside waiting for me and shouted excitedly to invisible people upstairs that I was there. The young girl had a history of DVT after recently giving birth and was given anti-coagulants by her doctor. This information changed my attitude – I had to take her obvious shortness of breath and chest pain seriously. It’s possible that a clot had travelled from her leg and settled in her lung, where it was occluding the blood flow and creating her current condition. It can be potentially life-threatening if left unchecked.

I gave her oxygen and gained IV access (just in case) but there was very little else I could do for her. She needed to go to hospital. Unfortunately for me (and her) there was a delay in getting an ambulance; at that time of the day a lot of crews have gone off-duty early because they haven’t had a break, so there is a shortage until the next shift starts - up to half an hour later. I had to wait with the patient for almost 30 minutes before a crew arrived to take over. All the while I calmed her and chatted to the family gathered around. I think I have honed my ability to lower stress in a room. I have seen this skill used many times to good effect by some of my colleagues – it’s the ability to change frowns to smiles and concern to confidence. My jokes are rubbish but they do the job.

Be safe.